【摘要】 目的探讨贝伐单抗靶向治疗晚期胃癌的疗效及对肠黏膜屏障功能、基质金属蛋白酶(MMP)-2、MMP-9的影响。方法将100例晚期胃癌患者随机分为观察组和对照组,每组50例。对照组给予顺铂联合多西紫杉醇常规化疗,观察组在对照组的基础上加用贝伐单抗靶向治疗。比较两组患者化疗前后血清MMP-2、MMP-9水平及肠黏膜屏障功能,观察两组患者临床疗效及不良反应发生情况。结果两组患者化疗前血清MMP-2、MMP-9、D乳酸、降钙素原、Ig A水平及尿乳果糖与甘露醇比值(L/M)比较,差异均无统计学意义(均P>0.05);两组患者化疗后血清MMP-2、MMP-9、D乳酸、降钙素原、Ig A水平均低于化疗前,尿L/M均高于化疗前,且观察组患者各指标较对照组改善更明显(均P<0.05)。观察组患者血小板减少、肝肾功能损害、骨髓抑制、白细胞减少及腹泻的严重不良反应率均低于对照组,但治疗有效率高于对照组(均P<0.05)。结论化疗加用贝伐单抗靶向治疗,可有效降低晚期胃癌患者血清MMP-2、MMP-9水平,改善肠黏膜屏障功能,减少严重不良反应的发生,提高临床疗效。更多还原

【Abstract】 Objective To investigate the efficacy of bevacizumab as targeted therapy for advanced gastric cancer and its effects on intestinal mucosal barrier function,matrix metalloproteinase(MMP)-2 and MMP-9. Methods A total of 100 patients with advanced gastric cancer were randomly divided into observation group and control group,with 50 cases in each group. The control group was given conventional chemotherapy of cisplatin combined with docetaxel,and the observation group was given targeted therapy using bevacizumab on the basis of the therapy in the control group. The serum levels of MMP-2 and MMP-9,as well as intestinal mucosal barrier function,were compared between the two groups before and after chemotherapy,and the clinical efficacy and incidence of adverse reactions were observed in both groups. Results There were no significant differences in the urinary lactulose to mannitol(L/M) ratio,serum level of MMP-2,MMP-9,D-lactate,procalcitonin or Ig A between the two groups before chemotherapy(all P > 0. 05). After chemotherapy,the serum levels of MMP-2,MMP-9,D-lactate,procalcitonin and Ig A were all lower and the urinary L/M ratio was higher in both groups compared to those before chemotherapy,and the improvement of the indexes above in the observation group were more significant than that in the control group(all P < 0. 05). The rates of thrombocytopenia,liver and kidney dysfunction,bone marrow suppression,leukocytopenia and severe adverse reactions due to diarrhea were lower but the effective rate of treatment was higher in the observation group than those in the control group(all P < 0. 05). Conclusion For patients with advanced gastric cancer,chemotherapy plus targeted therapy using bevacizumab can effectively reduce serum MMP-2 and MMP-9 levels,improve intestinal mucosal barrier function,decrease severe adverse reactions and enhance clinical efficacy.更多还原